HIV Self-testing Helps People Learn Status and Lower Risk

October 21st, 2020 | Story


Twenty-seven-year-old John has lived with the fear of contracting HIV almost since he began sexual activity. As a member of a close-knit community of men who have sex with men (MSM) in a Lagos suburb, John knows he is at risk of contracting HIV but says, “I am sexually active, so I know it is important to [use] condoms, but at times I just want to ‘go down’ as quickly as possible.”

The World Health Organization reports that people who have unprotected sex and multiple partners and who inject illicit drugs are at increased risk of HIV than the general population and classifies them as key populations (KPs). In Nigeria, KPs constitute about 1 percent of the adult population and account for about 23 percent of new HIV diagnoses. MSM, female sex workers (FSWs), and people who inject drugs are targeted for support because of their higher risk of contracting HIV.

Funded by the United States Agency for International Development under the Key Populations CARE 1 project, we implement the Total Market Approach (TMA). The TMA project supports the Nigerian government’s effort to expand HIV services by creating demand, improving coordination by convening and connecting public and private sector actors, and using data from all sectors of the market to understand annual national HIV commodity requirements and identify gaps. This knowledge also helps interventions in the three project states of Lagos, Akwa Ibom, and Cross River match supply with service. The TMA project’s Keep It Safe and Sweet (KISS) social media campaign increases awareness and promotes use of HIV prevention commodities including condoms, water-based lubricants, antiretroviral medication for pre-exposure prophylaxis (PrEP), and HIV self-test (HIVST) kits among KPs in Nigeria.

Between March and September 2020, the project reached more than 1,000 MSM and FSWs with HIV prevention messages via its dedicated WhatsApp, Facebook, Twitter, and Instagram platforms. John was among those who got these messages. “I have been hearing about PrEP but I had full knowledge of it after I joined the closed WhatsApp group set up for MSM by the TMA project.”

KISS Nigeria Twitter Post on PrEP
The TMA project is successfully using social media to deliver HIV prevention messages.

“I started using PrEP in July [2020] after a [HIV] test was conducted on me and I was found to be eligible,” he continues. In addition to John, the KISS campaign is convincing several KPs to learn their HIV status so they can find out if they are eligible for PrEP. The availability of self-testing is especially important for KPs, who fear stigma or harassment by authorities so seldom come out in the open for HIV tests. An MSM in one of the WhatsApp groups who used an HIVST kit at home shared his experience with his group peer educator: “Hey Frank! I just get tested for HIV and I’m negative! I was damn scared! And I am very happy now. Please, I’ll need to start PrEP.”

Whatsapp Nigeria Messaging
An MSM in one of the WhatsApp groups who used an HIVST kit at home shared his experience with his group peer educator.

With PEPFAR support, about 5,000 KPs and 1,550 sero-discordant couples are taking PrEP pills in Nigeria. “I started using PrEP to protect myself from getting HIV. Prevention, they say, is better than cure,” says 22-year-old Endorem, an MSM based in Akwa Ibom who also received the messages via the closed WhatsApp group.

For John, Endorem, and many other KPs in the TMA project states, awareness about self-testing and PrEP has allayed their fears of HIV and changed their behaviors for the better. At the time of this publication (October 2020), the project provided peer education services through its closed WhatsApp groups to 326 respondents, 136 of whom are on PrEP.

I am sexually active. As PrEP guarantees a high rate of HIV prevention, I will continue to use [it] religiously,” concludes John.

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